Format

Send to

Choose Destination
See comment in PubMed Commons below
Emerg Infect Dis. 2013;19(9):1374-84. doi: 10.3201/eid1909.130401.

Nodding syndrome.

Author information

1
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. sfd2@cdc.gov

Abstract

An epidemic illness characterized by head nodding associated with onchocerciasis has been described in eastern Africa since the early 1960s; we summarize published reports and recent studies. Onset of nodding occurs in previously healthy 5-15-year-old children and is often triggered by eating or cold temperatures and accompanied by cognitive impairment. Its incidence has increased in Uganda and South Sudan over the past 10 years. Four case-control studies identified modest and inconsistent associations. There were nonspecific lesions seen by magnetic resonance imaging, no cerebrospinal fluid inflammation, and markedly abnormal electroencephalography results. Nodding episodes are atonic seizures. Testing has failed to demonstrate associations with trypanosomiasis, cysticercosis, loiasis, lymphatic filariasis, cerebral malaria, measles, prion disease, or novel pathogens; or deficiencies of folate, cobalamin, pyridoxine, retinol, or zinc; or toxicity from mercury, copper, or homocysteine. There is a consistent enigmatic association with onchocerciasis detected by skin snip or serologic analysis. Nodding syndrome is an unexplained epidemic epilepsy.

KEYWORDS:

Africa; Nodding syndrome; South Sudan; Uganda; epidemic; epilepsy; head nodding; idiopathic; onchocerciasis; parasites; seizures

PMID:
23965548
PMCID:
PMC3810928
DOI:
10.3201/eid1909.130401
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for CDC-NCEZID Icon for PubMed Central
    Loading ...
    Support Center